RT Book, Section
A1 Dooley-Hash, Suzanne
A1 Knoop, Kevin J.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181041687
T1 Imperforate Hymen
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041687
RD 2024/10/03
AB The  hymen  is  normally  a  perforate  membrane  seen  at  the  vaginal  introitus  where  it  separates  the  vestibule  externally  from  the  vagina  internally.  Imperforate  hymen  refers  to  the  congenital  absence  of  a  hymenal  orifice.  This  condition  may  present  in  infants  or  young  children  as  a  smooth,  glistening  membrane  protruding  from  the  introitus  due  to  the  buildup  of  vaginal  secretions  known  as  a  mucocolpos.  More  commonly,  it  presents  in  adolescent  girls  with  the  accumulation  of  menstrual  blood  and  secretions  behind  the  hymen,  known  as  a  hematocolpos.  The  fluid  collection  can  become  large  enough  to  compress  the  bladder  neck  and  cause  urinary  retention.  Occasionally,  the  accumulated  blood  spilling  into  the  peritoneal  cavity  through  the  fallopian  tubes  results  in  free  pelvic  fluid  and  signs  of  peritonitis.  On  examination,  hematocolpos  is  evident  as  a  smooth,  dome-shaped,  bluish-red  bulging  membrane  at  the  introitus.  A  large,  smooth,  cystic  mass  can  often  be  palpated  anteriorly  on  digital  rectal  examination.